人免疫球蛋白治疗肝硬化合并感染105例

Human immunoglobulin for treatment of infection in patients with cirrhosis

目的:观察人体免疫球蛋白(immunoglobulin,IG)在肝硬化合并感染患者临床治疗中的应用疗效.方法:对东营市胜利油田中心医院收治肝硬化合并感染患者105例进行随机分组,对照组给予常规抗生素抗感染,观察组在对照组基础上加用IG,并采用Child-Pugh评分进行疗效观察.对各组患者血清总胆红素、血清白蛋白、谷丙转氨酶、总胆固醇以及凝血功能等指标进行检查.同时,观察治疗后两组患者的早期感染控制率以及治疗浅见的并发症情况.结果:患者Child-Pugh<10分时,两组患者感染控制率差异无统计学意义(P>0.05).ChildP u g h评分10-15分时,观察组感染控制率为84.00%,高于对照组的46.15%(P<0.05).此外,观察组在治疗期间发生2例二重感染,对照组则为8例.两组差异无统计学意义(P>0.05).此外,观察组与对照组分别有11例、13例患者主动出院或死亡,两组差异无统计学意义(P>0.05).结论:Child-Pugh评分10-15分的肝硬化患者应用IG,能够有效提高感染控制率,减少并发症.

AIM： To observe the clinical efficacy of immu- noglobulin （IG） in the treatment of infection in patients with cirrhosis. METHODS： One hundred and five cirrhotic pa- tients with an infection were randomized into either a control group or an observation group. The control group received routine antibiotic treatment, while the observation group was giv- en IG on the basis of routine antibiotic treatment and underwent efficacy evaluation using Child- Pugh scores. Serum total bilirubin （TB）, albumin, alanine aminotransferase （ALT）, total cholesterol （TC） and blood coagulation parameters were monitored. The rate of early infection control and incidence of complications were compared between the two groups. RESULTS： For patients with a Child-Pugh score 〈 10, the rate of early infection control was not statistically significant between the two groups （P 〉 0.05）. For patients with a Child-Pugh score between 10 and 15, the rate of infection control was significantly higher in the observation group than in the control group （84.00% vs 46.15%, P 〈 0.05）. Severe infection occurred during therapy in two cases in the observation group and in eight cases in the control group, and there was no sig- nificant difference in the number of cases of se- vere infection occurring during therapy between the two groups （P 〉 0.05）. In addition, 11 cases in the observation group and 13 cases in the control group were actively discharged from the hospital or died, and there was no statistically significant difference in the number of patients who were actively discharged from the hospital or died be- tween the two groups （P 〉 0.05）. CONCLUSION： IG can effectively improve the rate of infection control and reduce the incidence of complications during hospitalization and mortality in cirrhotic patients with a Child-Pugh score between 10 and 15.